title: [The lower legs amputation--rare side effects of acute poisoning].
abstract: The paper describes a case of suicidal poisoning with a combined hypotensive drug.
  
  
  METHODS
  A 46-year old man ingested, with a suicidal intent, a 0.5 l of vodka and around 20 tabl. of Tarka contains 180 mg of verapamil and 2 mg of trandolapril in 1 tablet. Despite intensive supportive treatment no reperfusion was achieved, and it was necessary to amputate both legs below knees.
  
  
  CONCLUSIONS
  Acute overdoses of Tarka may be severe in spite of relatively small amounts of drug ingested by patients (from 5 to 20 tablets). In light of reports of severe ischemic complications, which seem to have thrombotic etiology, it seems advisable to employ prophylaxis with anticoagulants, especially in patients with resistant hypotension. Ischemic complications, which may result in amputation, may present long time after hemodynamic stabilization is achieved.
authors.affiliation: Pomorskie Centrum Toksykologii, Gdańsk. jacek.anand@gmail.com
authors.forename: Jacek
authors.initials: J
authors.lastname: Sein Anand
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Barwina
authors.forename: Anna
authors.initials: A
authors.lastname: Wiśniewska
mesh_terms: D000671:Amputation, Surgical; D004338:Drug Combinations; D062787:Drug Overdose; D000431:Ethanol / Q000008:administration & dosage / Q000506:poisoning*; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000506:poisoning*; D007511:Ischemia / Q000139:chemically induced*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted; D014700:Verapamil / Q000008:administration & dosage / Q000506:poisoning*
chemical_list: D004338:Drug Combinations; D007211:Indoles; C052035:trandolapril; D000431:Ethanol; D014700:Verapamil